Tricyclic antidepressants and fibromyalgia: what is the mechanism of action?

被引:25
作者
Lawson, K
机构
[1] Sheffield Hallam Univ, Sch Sci & Math, Ctr Biomed Res, Sheffield S1 1WB, S Yorkshire, England
[2] Sheffield Hallam Univ, Sch Sci & Math, Div Biomed Sci, Sheffield S1 1WB, S Yorkshire, England
关键词
channelopathies; fibromyalgia; NMDA receptors; potassium channels; tricyclic antidepressants;
D O I
10.1517/13543784.11.10.1437
中图分类号
R9 [药学];
学科分类号
1007 ;
摘要
Fibromyalgia is a chronic pain disorder of which other clinical features, such as persistent fatigue and disordered sleep, may be a secondary consequence. The initial pharmacological approach to treating the disorder is the management of the pain. Tricyclic antidepressants are the most effective drugs in use so far, especially when administered in combination with other therapies (e.g., selective serotonin re-uptake inhibitors), which suggests modulation of the neurotransmitters serotonin and noradrenaline. The effectiveness of amitriptyline and related tricyclic antidepressants, however, is consistent with the involvement of mechanisms, such as potassium channel modulation and NMDA receptor antagonism, in addition to or in place of the modulation of monoamine neurotransmitters. Investigation of the importance of each of the pharmacological properties of amitriptyline and related molecules in the management of fibromyalgia could provide clues for the rational design of new drugs.
引用
收藏
页码:1437 / 1445
页数:9
相关论文
共 107 条
[1]   Axotomy- and autotomy-induced changes in Ca2+ and K+ channel currents of rat dorsal root ganglion neurons [J].
Abdulla, FA ;
Smith, PA .
JOURNAL OF NEUROPHYSIOLOGY, 2001, 85 (02) :644-658
[2]   Oscillatory mechanism in primary sensory neurones [J].
Amir, R ;
Liu, CN ;
Kocsis, JD ;
Devor, M .
BRAIN, 2002, 125 :421-435
[3]   Citalopram in patients with fibromyalgia - a randomized, double blind, placebo-controlled study [J].
Anderberg, UM ;
Marteinsdottir, I ;
von Knorring, L .
EUROPEAN JOURNAL OF PAIN-LONDON, 2000, 4 (01) :27-35
[4]   A-G PROTEIN COUPLES SEROTONIN AND GABA-B RECEPTORS TO THE SAME CHANNELS IN HIPPOCAMPUS [J].
ANDRADE, R ;
MALENKA, RC ;
NICOLL, RA .
SCIENCE, 1986, 234 (4781) :1261-1265
[5]   A randomized, placebo-controlled, double-blind, flexible-dose study of fluoxetine in the treatment of women with fibromyalgia [J].
Arnold, LM ;
Hess, EV ;
Hudson, JI ;
Welge, JA ;
Berno, SE ;
Keck, PE .
AMERICAN JOURNAL OF MEDICINE, 2002, 112 (03) :191-197
[6]   Ion channel mutations affecting muscle and brain [J].
Barchi, RL .
CURRENT OPINION IN NEUROLOGY, 1998, 11 (05) :461-468
[7]   A randomized, double-blind, placebo-controlled study of growth hormone in the treatment of fibromyalgia [J].
Bennett, RM ;
Clark, SC ;
Walczyk, J .
AMERICAN JOURNAL OF MEDICINE, 1998, 104 (03) :227-231
[8]   A COMPARISON OF CYCLOBENZAPRINE AND PLACEBO IN THE MANAGEMENT OF FIBROSITIS - A DOUBLE-BLIND CONTROLLED-STUDY [J].
BENNETT, RM ;
GATTER, RA ;
CAMPBELL, SM ;
ANDREWS, RP ;
CLARK, SR ;
SCAROLA, JA .
ARTHRITIS AND RHEUMATISM, 1988, 31 (12) :1535-1542
[9]   Emerging concepts in the neurobiology of chronic pain: Evidence of abnormal sensory processing in fibromyalgia [J].
Bennett, RM .
MAYO CLINIC PROCEEDINGS, 1999, 74 (04) :385-398
[10]  
Biasi G, 1998, INT J CLIN PHARM RES, V18, P13